<!DOCTYPE html>
<html>
<meta charset="utf-8">
<head th:include="include :: header"></head>
<body class="gray-bg">
	<div class="wrapper wrapper-content ">
		<div class="row">
			<div class="col-sm-12">
				<div class="ibox float-e-margins">
					<div class="ibox-content">
						<form class="form-horizontal m-t" id="signupForm">
							<div class="form-group">	
								<label class="col-sm-3 control-label">商户用户标识：</label>
								<div class="col-sm-8">
									<input id="userId" name="userId" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">支付公司：</label>
								<div class="col-sm-8">
									<input id="payCompany" name="payCompany" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">支付商户：</label>
								<div class="col-sm-8">
									<input id="payMerch" name="payMerch" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">快捷签约：</label>
								<div class="col-sm-8">
									<input id="sign" name="sign" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">其他一些支付信息：</label>
								<div class="col-sm-8">
									<input id="info" name="info" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">持卡人姓名：</label>
								<div class="col-sm-8">
									<input id="acctName" name="acctName" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">账户类型：</label>
								<div class="col-sm-8">
									<input id="acctType" name="acctType" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">银行卡号：</label>
								<div class="col-sm-8">
									<input id="bankNo" name="bankNo" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">证件类型 1身份证：</label>
								<div class="col-sm-8">
									<input id="certType" name="certType" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">证件号码：</label>
								<div class="col-sm-8">
									<input id="certNo" name="certNo" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">手机号码：</label>
								<div class="col-sm-8">
									<input id="pone" name="pone" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">信用卡背面cvv2码后三位：</label>
								<div class="col-sm-8">
									<input id="cvv2" name="cvv2" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">有效期，年月，四位数，例：2112：</label>
								<div class="col-sm-8">
									<input id="varlidDate" name="varlidDate" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">1-快捷支付 2-代扣扣款：</label>
								<div class="col-sm-8">
									<input id="collType" name="collType" class="form-control" type="text">
								</div>
							</div>
																					<div class="form-group">
								<div class="col-sm-8 col-sm-offset-3">
									<button type="submit" class="btn btn-primary">提交</button>
								</div>
							</div>
						</form>
					</div>
				</div>
			</div>
	</div>
	</div>
	<div th:include="include::footer"></div>
	<script type="text/javascript" src="/js/appjs/pay/merchUserSign/add.js">
	</script>
</body>
</html>
